Accuracy of obstetric diagnoses and procedures in hospital discharge data

Yasmeen, Shagufta; Romano, Patrick S.; Schembri, Michael; Keyzer, Janet; Gilbert, William M.

doi:10.1016/j.ajog.2005.08.058

Cited by 266 publications

(249 citation statements)

References 18 publications

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“…Two recent studies have however shown hospital discharge data to reflect accurately major diagnoses and procedures. 25,26 We attempted to overcome the possibility of this type of error by grouping diagnoses into broad categories. Third, this study is limited to rehospitalization during the first year of life.…”

Section: Discussionmentioning

confidence: 99%

Cost, causes and rates of rehospitalization of preterm infants

Danielsen²,

2007

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Objective: To examine hospital readmissions for premature infants during the first year of life.Study Design: The California maternal and newborn/infant hospital discharge records were examined for subsequent readmission during the first year of life for all newborns from 1992 to 2000. Discharge diagnoses, hospital days, demographic data and hospital charges for infants born preterm (<36 weeks gestation) were identified and evaluated.Result: About 15% of preterm infants required at least one rehospitalization within the first year of life (average cost per readmission $8468, average annual cost in excess of $41 million). Infants with gestational age <25 weeks had the highest rate of readmission (31%) and longest average length of stay (12 hospital days). The largest cohort, infants born at 35 weeks gestation, had the highest total cost of readmission ($92.9 million). The most common cause of rehospitalization was acute respiratory disease. There was no decrease in the number or cost of readmissions of premature infants for respiratory syncytial virus infections following the introduction of palivizumab in 1998. Conclusion:After initial discharge, premature infants continue to have significant in-patient health-care needs and costs.

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Section: Discussionmentioning

confidence: 99%

Cost, causes and rates of rehospitalization of preterm infants

Danielsen²,

2007

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“…The median number of pregnancies per mother during the study period was 1 (interquartile range [IQR] 1-2; range 1-11). The median maternal age at delivery was 30 years (IQR [26][27][28][29][30][31][32][33][34]. The prevalence of at least one recorded preexisting medical condition, including hypertension, diabetes mellitus, or chronic kidney disease, was 5.3%.…”

Section: Pregnancies In Ontario Canadamentioning

confidence: 99%

“…Whenever possible, we defined pregnancy characteristics andmaternal and perinatal outcomes usingdatabase codesthat have been proven feasible and reliable in prior studies. [26][27][28][33][34][35][36][37] These codes typically have high specificity and modest sensitivity for capturing the variable of interest. Detailed information on coding definitions and validity is provided in Supplemental Table 4.…”

Section: Data Sourcesmentioning

confidence: 99%

Characteristics and Outcomes of AKI Treated with Dialysis during Pregnancy and the Postpartum Period

Hildebrand

Liu

Shariff

et al. 2015

Journal of the American Society of Nephrology

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Acute kidney injury (AKI) is a rare complication of pregnancy, but may be associated with significant morbidity and mortality in young and often otherwise healthy women. We conducted a retrospective population-based cohort study of all consecutive pregnancies over a 15-year period (1997-2011) in Ontario, Canada, and describe the incidence and outcomes of AKI treated with dialysis during pregnancy or within 12 weeks of delivery. Of 1,918,789 pregnancies, 188 were complicated by AKI treated with dialysis (incidence: 1 per 10,000 [95% confidence interval, 0.8 to 1.1]). Only 21 of 188 (11.2%) women had record of a preexisting medical condition; however, 130 (69.2%) women experienced a major pregnancy-related complication, including preeclampsia, thrombotic microangiopathy, heart failure, sepsis, or postpartum hemorrhage. Eight women died (4.3% versus 0.01% in the general population), and seven (3.9%) women remained dialysis dependent 4 months after delivery. Low birth weight (,2500 g), small for gestational age, or preterm birth (,37 weeks' gestation) were more common in pregnancies in which dialysis was initiated (35.6% versus 14.0%; relative risk, 3.40; 95% confidence interval, 2.52 to 4.58). There were no stillbirths and fewer than five neonatal deaths (,2.7%) in affected pregnancies compared with 0.1% and 0.8%, respectively, in the general population. In conclusion, AKI treated with dialysis during pregnancy is rare and typically occurs in healthy women who acquire a major pregnancy-related medical condition such as preeclampsia. Many affected women and their babies have good short-term outcomes. 26: 3085-3091, 201526: 3085-3091, . doi: 10.1681 Pregnancy-related AKI is associated with significant morbidity and mortality inyoung and often otherwise healthy women. 1,2 Since the 1960s, the incidence of pregnancy-related AKI in developed countries has declined from 1 in 3000 to 1 in 18,000. 1 This trend has been closely linked to improved obstetrical care and dramatic reductions in first-trimester AKI attributable to septic abortions. 2 However, these trends are less relevant in contemporary populations. The changing risk profile of pregnant North American women includes lower parity, older age, higher body mass index, and greater comorbidities such as hypertension, diabetes mellitus, and chronic kidney disease, as well as increased use of reproductive technologies resulting in multiple gestations. These changes may have a unique impact on the incidence, etiology, and outcomes of pregnancy-related AKI. [3][4][5][6][7] J Am Soc Nephrol

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“…Com relação ao emprego do SIH-SUS em ações de vigilância e monitoramento de doenças em nível populacional, deve-se propor que a base seja previamente escrutinada a cada agravo a ser avaliado, e sua adequação vista sempre de forma conjuntural e mutável no tempo 1,11,27,28 …”

Section: Discussionunclassified

Sistema de informações hospitalares do sistema único de saúde (SIH-SUS): uma avaliação preliminar do seu desempenho no monitoramento da doença hemolítica perinatal Rh(D)

2008

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Considerando a utilização de bases administrativas na vigilância epidemiológica, propõe-se aqui avaliar a adequação do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) na identificação dos casos de doença hemolítica perinatal ocorridos no Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/FIOCRUZ), entre 1998 e 2003. Foram analisadas informações disponibilizadas pelo Serviço Neonatal, pelo Arquivo Médico e os dados da Autorização de Internação Hospitalar (AIH) consolidados no SIH-SUS. A identificação dos casos de doença hemolítica perinatal se deu através dos campos Diagnóstico Primário, Diagnóstico Secundário e Procedimento Realizado. Nesse período, 194 neonatos foram diagnosticados com doença hemolítica perinatal. No Arquivo Médico, 148 casos foram registrados, porém apenas 147 AIHs foram emitidas e 145 consolidadas no SIH-SUS. Entre essas, 84 AIHs arrolavam a doença hemolítica perinatal como Diagnóstico Primário; considerando também o Diagnóstico Secundário, mais 38 casos foram identificados; e nenhum caso adicional foi recuperado pelo Procedimento Realizado. Assim, o SIH-SUS identificou apenas 122 (62,9%) dos 194 neonatos com doença hemolítica perinatal assistidos no IFF/FIOCRUZ. Mesmo que ainda requerendo uma reavaliação em outros hospitais, a utilização do SIH-SUS no monitoramento da doença hemolítica perinatal não parece recomendável. Estudos ancilares são necessários quando do emprego de dados secundários nesse contexto.

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Accuracy of obstetric diagnoses and procedures in hospital discharge data

Cited by 266 publications

References 18 publications

Cost, causes and rates of rehospitalization of preterm infants

Cost, causes and rates of rehospitalization of preterm infants

Characteristics and Outcomes of AKI Treated with Dialysis during Pregnancy and the Postpartum Period

Sistema de informações hospitalares do sistema único de saúde (SIH-SUS): uma avaliação preliminar do seu desempenho no monitoramento da doença hemolítica perinatal Rh(D)

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